THE MALE PREDOMINANCE IN THE INCIDENCE OF INFECTIOUS-DISEASES IN CHILDREN - A POSTULATED EXPLANATION FOR DISPARITIES IN THE LITERATURE
THE MALE PREDOMINANCE IN THE INCIDENCE OF INFECTIOUS-DISEASES IN CHILDREN - A POSTULATED EXPLANATION FOR DISPARITIES IN THE LITERATURE
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DOI：
10.1093/ije/21.2.381
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发表时间：
1992-04-01
影响因子：
7.7
通讯作者：
GREEN, MS
中科院分区：
文献类型：
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作者：
GREEN, MS
据报道，在儿童中，某些传染原的症状性疾病发病率以男性为主，而其他传染原则不然。不仅人们对这些性别差异背后的因素知之甚少，而且还不清楚为什么仅针对某些传染病描述了这些差异。在这项针对儿童传染病的性别和年龄特定发病率的研究中，探讨了文献中不一致的可能解释。对以色列大约 20 年期间报告的疾病发病率的性别比例进行了检查，以了解各种病毒和细菌感染。此外，还开发了一个假设的数学模型，假设一定比例的男性对传染病的易感性增加（例如相对免疫缺陷）。在 4 岁以下儿童中，所有疾病的男性发病率均较高，性别比例在志贺氏菌病的 1.16（95% 置信区间 (CI)：1.13-1.18）和病毒性脑膜炎的 1.98（95% CI：1.79-2.17）之间变化。最高比率与最常出现无症状的疾病相关，这与模型的预测一致。大多数传染病似乎都存在有症状疾病的男性过多，在比较不同性别比例的群体之间观察到的疾病发病率的研究中应考虑到这一点。关于男性传染病发病率过高的报告不一致可能是由于有症状与无症状感染比例的差异所致。
In children, a male predominance in the incidence of symptomatic disease has been reported for some infectious agents and not for others. Not only are the factors underlying these sex differences poorly understood, but it is also not clear why the differences are described only for selected infectious diseases. In this study of sex- and age-specific incidence of infectious diseases in children, a possible explanation for the inconsistencies in the literature was explored. The sex ratio in reported disease incidence in Israel during a period of about 20 years was examined for various viral and bacterial infections. In addition, an hypothetical mathematical model was developed which assumes increased susceptibility to infectious disease (such as in relative immune deficiency) in a proportion of males. In children aged under 4 years, a higher incidence among males was consistently observed for all diseases, and the sex ratio varied between 1.16 (95% confidence interval (CI): 1.13-1.18) for shigellosis to 1.98 (95% CI: 1.79-2.17) for viral meningitis. The highest ratios were associated with the diseases which tend to present asymptomatically most often, which is consistent with the predictions of the model.The male excess in symptomatic disease appears to be present for most infectious diseases and this should be taken into account in studies comparing observed disease incidence between groups with different sex ratios. The inconsistencies in reports on the excess male morbidity for infectious diseases may be due to variations in symptomatic to asymptomatic infection ratios.